Prescription for pharmacist: A change in dosage
WEST LAFAYETTE, Ind. If the pace of filling prescriptions continues to advance at its current rate, it soon may take you longer to open a child-proof container than it takes a pharmacist to fill a dozen medicine bottles.
"Fifteen years ago a pharmacist considered it a very busy day to fill 100 prescriptions in a single day, but today they fill twice that many on an average day," says Patrick George, associate director of Purdue University's pharmaceutical student services office. "Also, our current technology allows up to 500 prescriptions to be filled in a single day."
Figures from the National Association of Chain Drug Stores support George's observation. About three billion prescriptions were filled in 1998, up from two billion in 1992. This number is expected to reach four billion by 2005.
There are several reasons for the increased demand for prescriptions, including the health needs of an aging population, the availability of new drugs, and the steady increase of co-pay insurance programs.
These changes, along with the rise of chain drug stores, have caused a national shortage of practicing pharmacists. Educators say a change in the practice of pharmacy, rather than an increase in the number of retail pharmacists, is the way to respond to the shortage.
"As a whole, universities cannot dramatically increase the number of graduates in the field of pharmacy. This is because the educational and physical facilities needed to teach a certified pharmacist just aren't susceptible to rapid change," says Charles O. Rutledge, dean of Purdue's Schools of Pharmacy, Nursing and Health Sciences. "At Purdue, we graduate between 150 and 200 certified pharmacists each year, and we have one of the largest programs in the country."
Although the number of practicing pharmacists is not expected to grow to meet the demand, there are several ways to lessen the demands on the typical pharmacist.
"In Indiana, a pharmacist can have four assisting technicians at a given time, and that is a help," George says. "Also, a change in the 'third-party' system is imperative."
The third-party system requires the pharmacist to spend a good part of the day coordinating a variety of insurance payment plans.
"Pharmacist have to take the time to figure out the insurance program of each patient, and make sure the prescription they have is covered by that insurance, and if it isn't they have to call the doctor and find out if there is another drug that is covered by the insurance the doctor might want prescribe instead," George says. "It's all very complicated and time consuming."
Statistics show the average pharmacist spends up to 22 percent of each day on these types of matters, and that intensifies the need for more retail pharmacists.
"Right now retail pharmacy is in such high demand that our graduates get an average of three offers each, and just over 85 percent will go to work for a major drug store chain" George says.
About 5 percent of pharmaceutical graduates will go work for an independent retail store, 4 percent enter a hospital environment, another 4 percent will find employment in the nuclear pharmaceutical field, which focuses on the use of radioactive drugs for medical diagnosis and therapy, and 2 percent will accept jobs in industry.
One reason pharmacy graduates choose retail work is that salaries in that field have risen in tandem with the demand. In 1996 the average annual pay was $56,027. Three years later the average retail chain salary rose to $65,353 more than a 16 percent increase. Current salaries in other pharmaceutical fields range from $54,000 to $60,000.
"That's part of it, but also the majority of students say 'patient care' draws them to the pharmaceutical profession," says George, who worked for several years as a retail pharmacist. "There's also a 'serving attitude,' and positive feedback from the customers, respect from the public and the flexibility you get in that environment. In today's market, pharmacists can live where they want and know they will have a job, and if they want to work part-time they can do that too."
Future pharmacists will find that additional changes in the field, such as a greater emphasis on patient care and stricter standards for accreditation, will widen those choices even further.
"Like most universities, we've moving to a six-year Pharm D degree, which is different from the five-year baccalaureate degree in pharmacy in that there is a focus on teaching critical thinking skills and the ability to keep learning," Rutledge says. "The educators' mission has changed to therapeutic management with the focus on the overall health of the patient."
After 2003, the traditional five-year pharmaceutical degree will not be offered at Purdue.
"This is a change at many universities, and it is part of what we're calling 'Responsibility for Outcome.' That means the pharmacist is more in contact with the doctor and is more active in communicating the overall health goals with the patient," says George. "In other words, the goal is for the pharmacist to work hand-in-hand with the doctor and decide together how best to serve the patient."
Sources: Charles O. Rutledge, (765) 494-1368, firstname.lastname@example.org
Patrick George, (765) 494-5812, email@example.com
Writer: Cynthia Sequin, (765) 494-2073. firstname.lastname@example.org
Purdue News Service: (765) 494-2096; email@example.com